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i <br /> QU�NENVIRONMENTAL HEALTH DEPARTMENT <br /> SAN JOAQUINC <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> y: :{ Telephone: (209)468-3420 Fax(209)468-3433 Ec s,, <br /> INFORMATION PACKET FOR MEDICALWASTE GENERAT 2013 <br /> This packet contains the information and forms you will need to help you comply �N T-�"- I <br /> Medical Waste Management Act. <br /> Instructions4'; <br /> Please return the completed forms prior to medical waste generation or treatment 11 111 1VTALHE, l: <br /> pawww <br /> I Complete the "Pre-ApplicationQuestionnaire" on Page 2. If your answers indicate <br /> you are not required to register as a medical waste generator,then complete the <br /> "Certification Statement" on Page 3 and return both complete forms to the mailing <br /> address below. <br /> 2. If you are required to register as a medical waste generator, as indicated by affirmative <br /> answers to questions 3 &4 on the "Pre-Application Questionnaire",then: <br /> a. Complete the "Registration for Medical Waste" form located on <br /> Page 4. <br /> b. Complete a"Medical Waste Management Plan"following the guidelines <br /> provided on Page 5. <br /> c. Return the completed forms and management plan to the mailing address <br /> below. <br /> Your cooperation in promptly registering and following the specified handling requirements is <br /> greatly appreciated. <br /> If you have any questions regarding registration or handling requirements,please contact(209) <br /> 468-3420 and ask for the Medical Waste Program. <br /> RETURN ALL COMPLETED FORMS TO: <br /> Attn: Medical Waste Program <br /> San Joaquin County Environmental Health Department <br /> 1868 East Hazelton Avenue <br /> Stockton, CA 95205-6232 <br /> EHD 45-03 WEB 1 <br /> 04/18/08 <br />